U.S. Pat. No. 4,414,967 describes rapidly and reproducibly imparting a controlled amount of energy from a stapler to a staple to drive the staple into bone, and U.S. Pat. Nos. 4,500,025; 4,540,110; 4,527,726; 4,569,469; and 4,648,541 describe various bone stapler embodiments adapted to drive staples into bone in the manner described in U.S. Pat. No. 4,414,967. While such stapling of bone has proved quite successful for many types of procedures, there are procedures in which it is desirable to drive a screw or nail like insert into bone, for example to attach items such as ligaments to bones. Heretofore such inserts could only be applied manually through the use of manually manipulated hammers or screwdrivers which is a slow process, and presents problems of unwanted transverse relative movement as the inserts are engaged with the bone.